I am in charge of falls in my facility. We actually have a fall committee; me, hskp supervisior, social service, therapist and maintenance. We do fall round first business day after a fall. We all go to the room and attempt to determine what events happened that led up to the fall. If the resident is alert, they are included. If the staff member that was present is in the building they come too.
Our fall interventions include lots of non-skid strips beside beds and in front of toilet. Also use anti-tippers, alarms, wedge cushions, stop signs (big red signs) taped to the inside of the foot board reminding them to call for help, stop signs in bathrooms, even a few stop signs taped to the arms of the w/c's. Have also requested orders for Vesicare on one constantly going to bathroom and forgetting to get help (turns out that after multiple falls - this actually worked and we could keep her toileted on a routine schedule and she wouldn't try to go inbetween times
)!. Therapy is required to screen all fallers. This adds positioning devices such as bolsters or even Broda chairs for those determined with no reasonable sitting balance and unable to propel self anyways.
Remember the basics too. Had a demented (but dignified) guy just this week that kept trying to get up. Kept telling him to sit down. Finally leaned down, looked him in the eye and asked "why are you getting up". He told me he was sitting on something. I helped him stand just a bit while an aide reached under him and found nothing on the chair. Put him back, but he kept trying to stand. After some more quiet questioning, he admitted he was "sitting on my balls"
. Got help, got him all fixed and that was the end of that. (My funny of the week and so glad this was a fall prevention!).
Unfortunately, 75% of my nurses do not do a good job of initiating fall prevention methods at the time of the fall. They are finally doing a better job of including on the incident report if the alarms were sounding, if the floor was wet, if the resident had shoes on, etc.
PS, I was at some seminar within the last 6 months that indicated that in the future alarms may become considered psychological restraints... jeesh!